What role do corticosteroids play in the management of acute exacerbations of COPD, and what is the optimal dosing regimen?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

The role of corticosteroids in the management of acute exacerbations of COPD is to reduce inflammation, improve lung function, and decrease the duration and severity of exacerbations, thereby reducing hospital admissions and relapses .

The optimal dosing regimen is typically 30 mg of oral prednisolone daily for 5 days, with no need for dose tapering, and it should be given in conjunction with other therapies .

In hospital settings, oral corticosteroids are preferred if the person can swallow and retain them, as they have similar efficacy to IV corticosteroids .

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